Relating to the evaluation of Medicaid-managed care long-term services and supports

This bill relates to Medicaid managed long-term services and supports (LTSS). The bill requires the department of health and human services (HHS) to contractually require each Medicaid managed care organization (MCO) to report each quarter specific information from the previous quarter regarding the LTSS population members covered by the MCO including data related to the total amount expended on the LTSS population categorized by institutional and noninstitutional setting and by target population; reductions or increases in the total amount expended by setting and target population and the reasons for the reduction or increase; and trends identified in expenditures and services provided. The bill also requires HHS to convene stakeholders with expertise or interest in the LTSS population to review existing metrics for the managed LTSS population to determine if the current metrics provide constructive information to ensure the population is receiving access to necessary services and supports, that person-centered care and decision making are being promoted, and that the delivery system is not resulting in adverse selection or creating incentives to underserve or deny claims for members. The stakeholder group is required to review national LTSS population evaluation tools and metrics and make recommendations to the governor and the general assembly by October 1, 2023, for data collection based on a core set of LTSS-specific metrics.